Neuroimaging and fluid biomarkers in Parkinson’s disease in an era of targeted interventions

• Published in: Nature communications Vol. 15; no. 1; pp. 5661 - 18
• Main Authors: Zarkali, Angeliki, Thomas, George E. C., Zetterberg, Henrik, Weil, Rimona S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 05.07.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 13; 49; 49/62; 59/36; 59/57; 59/78; 631/378/1689/1718; 692/53; 692/617/375/1718; Biomarkers; Biomarkers - metabolism; Brain - diagnostic imaging; Brain - metabolism; Brain - pathology; Brain research; Clinical trials; Dementia; Diagnosis; Disease; Disease Progression; Dopamine; Extracellular Vesicles - metabolism; Glucose; Health services; Heterogeneity; Humanities and Social Sciences; Humans; Ligands; Medical imaging; Metabolism; multidisciplinary; Neurochemistry; Neurodegeneration; Neurodegenerative diseases; Neuroimaging; Neuroimaging - methods; Neurosciences; Neurovetenskaper; Parkinson Disease - diagnosis; Parkinson Disease - diagnostic imaging; Parkinson Disease - metabolism; Parkinson's disease; Patients; Perspective; Science; Science (multidisciplinary); Scintigraphy; Signs and symptoms; Tomography
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-024-49949-9

A major challenge in Parkinson’s disease is the variability in symptoms and rates of progression, underpinned by heterogeneity of pathological processes. Biomarkers are urgently needed for accurate diagnosis, patient stratification, monitoring disease progression and precise treatment. These were previously lacking, but recently, novel imaging and fluid biomarkers have been developed. Here, we consider new imaging approaches showing sensitivity to brain tissue composition, and examine novel fluid biomarkers showing specificity for pathological processes, including seed amplification assays and extracellular vesicles. We reflect on these biomarkers in the context of new biological staging systems, and on emerging techniques currently in development. Biomarkers are needed in Parkinson’s for accurate diagnosis, to monitor progression and for targeted treatment. The authors reflect on recent imaging and fluid biomarkers for Parkinson’s and consider challenges in bringing them into clinical use.